Impact of age and sex on survival after curative resection for carcinoma of the esophagus

Badwe, Rajendra; Patil, Prakash K.; Bhansali, Mehul; Mistry, Rajesh C.; Juvekar, R; Desai, P. B.

doi:10.1002/1097-0142(19941101)74:9<2425::aid-cncr2820740906>3.0.co;2-1

Cited by 25 publications

(9 citation statements)

References 26 publications

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“…Esophageal cancer is highly lethal with 11,650 (88.7%) estimated deaths among men and 2,850 (81.2%) among women. 2 Taken together with previous population studies, [3][4][5][6][7][8][9] the latter suggests a survival benefit for women when compared with men. The prevalence of the two main histologic subtypes-adenocarcinoma and squamous cell carcinoma-differs depending on geographic location.…”

Section: Introductionmentioning

confidence: 98%

Influence of Sex on the Survival of Patients With Esophageal Cancer

Bohanes

Yang

Chhibar

et al. 2012

JCO

116

115

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A B S T R A C T PurposeThe prognostic value of sex for esophageal cancer survival is currently unclear, and growing data suggest that hormonal influences may account for incidence disparities between men and women. Therefore, moving from the hypothesis that hormones could affect the prognosis of patients with esophageal cancer, we investigated the primary hypothesis that sex is associated with survival and the secondary hypotheses that the relationship between sex and survival depends, at least in part, on age, histology, and race/ethnicity. Patients and MethodsBy using the SEER databases from 1973 to 2007, we identified 13,603 patients (34%) with metastatic esophageal cancer (MEC) and 26,848 patients (66%) with locoregional esophageal cancer (LEC). Cox proportional hazards model for competing risks were used for analyses. ResultsIn the multivariate analysis, women had longer esophageal cancer-specific survival (ECSS) than men in both MEC (hazard ratio [HR], 0.949; 95% CI, 0.905 to 0.995; P ϭ .029) and LEC (HR, 0.920; 95% CI, 0.886 to 0.955; P Ͻ .001) cohorts. When age and histology were accounted for, there was no difference for ECSS between men and women with adenocarcinoma. In contrast, women younger than age 55 years (HR, 0.896; 95% CI, 0.792 to 1.014; P ϭ .081) and those age 55 years or older (HR, 0.905; 95% CI, 0.862 to 0.950; P Ͻ .001) with squamous cell LEC had longer ECSS than men. In the squamous cell MEC cohort, only women younger than age 55 years had longer ECSS (HR, 0.823; 95% CI, 0.708 to 0.957; P ϭ .011) than men. ConclusionSex is an independent prognostic factor for patients with LEC or MEC. As secondary hypotheses, in comparison with men, women age 55 years or older with squamous cell LEC and women younger than age 55 years with squamous cell MEC have a significantly better outcome. These last two findings need further validation.

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Section: Introductionmentioning

confidence: 98%

Influence of Sex on the Survival of Patients With Esophageal Cancer

Bohanes

Yang

Chhibar

et al. 2012

JCO

116

115

View full text Add to dashboard Cite

show abstract

“…The gender of the patient was found to be the second most significant determinant of survival (p = 0.002) after lymph node metastasis. These results of better survival benefit for women provides support for the hypothesis that the endocrine milieu in premenopausal women may prevent the micrometastases of the oesophageal malignancy and the consequent improved prognosis for oesophageal cancer [26]. …”

Section: Introductionmentioning

confidence: 76%

“…Badwe et al (1994) studied the impact of age and sex on survival after curative resection for carcinoma of the oesophagus with life stable analysis showing a significantly better 5 year survival for women under 49 years of age (35%, CI 24-48) compared with men of the same age (16%.CI 8-27) (P < 0.008)[26]. The gender of the patient was found to be the second most significant determinant of survival (p = 0.002) after lymph node metastasis.…”

Section: Introductionmentioning

confidence: 99%

Probing the link between oestrogen receptors and oesophageal cancer

2010

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BackgroundHuman oesophageal carcinoma is considered to be one of the most aggressive malignancies and has a very poor prognosis. The incidence of oesophageal cancer shows a gender bias and is higher in males compared with females, the ratio between males and females varying from 3:1 to 7:1. This sex ratio is not entirely attributable to differences in the prevalence of known risk factors between the sexes. The potential role of oestrogen receptors (ER) in oesophageal cancer has been debated for several years but the significance of the receptors in this cancer remains unknown. Most of the work has been based on immunohistochemistry and has not been validated with other available techniques. The inconsistencies in the published literature on the link between ER expression and oesophageal cancer warrant a thorough evaluation of the potential role of ERs in this malignancy. Even the expression of the two ER isoforms, ERα and ERβ, and its implications for outcome of treatments in histological subtypes of oesophageal tumours is ill defined. The aim of this article is to provide updated information from the available literature on the current status of ER expression in oesophageal cancer and to discuss its potential therapeutic role.Methods and ResultsWe performed a comprehensive literature search and analysed the results regarding ER expression in oesophageal tumours with special emphasis on expression of different oestrogen receptors and the role of sex hormones in oesophageal cancer. This article also focuses on the significance of the two main ER subtypes and mechanisms underlying the presumed male predominance of this disease.ConclusionWe postulate that differential oestrogen receptor status may be considered a biomarker of poor clinical outcome based on tissue dedifferentiation or advanced stage of the disease. Further, if we can establish the importance of oestrogen and its receptors in the context of oesophageal cancer, then this may lead to a new future direction in the management of this malignancy.

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“…Wichmann et al [17] reported that women with colorectal cancer had more favorable outcomes than men. Badwe et al [18] reported that young women with esophageal cancer showed a survival advantage. Furthermore, other reports have shown that long-term survival after surgical resection of the esophagus is better in women than in men [9,19].…”

Section: Discussionmentioning

confidence: 99%

Gender differences in clinicopathologic features and outcomes of esophageal cancer patients treated surgically

et al. 2011

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Background We investigated the clinicopathologic features and long-term outcomes after surgery of Japanese women with esophageal cancer in comparison to those of men. Methods A total of 136 patients with esophageal cancer were surgically treated between 1996 and 2008 (22 [16.2%] women and 114 men). Gender differences in these patients were retrospectively investigated. Results Women undergoing esophagectomy for esophageal cancer showed lower frequencies of cigarette smoking (p \ 0.0001) and alcohol consumption (p \ 0.0001) compared to men. Preoperative co-morbidities in women were fewer than those in men (p \ 0.001). Regarding the clinicopathologic features of esophageal cancer, women frequently had superficial cancer and no node metastasis (p \ 0.05). Women had lower-level morbidity after surgery (p \ 0.05), but no mortality after surgery was observed in men or women. Although there was no difference in other causes of death after surgery between them, recurrence/metastasis after surgery was more frequent in men than women (p \ 0.05). The 5-year survival rate after surgery was higher in women than men (p \ 0.05), but gender difference was not an independent prognostic factor. Conclusions Significant gender differences in patients with esophagectomy were observed regarding the preoperative condition, clinicopathologic features, postoperative condition, and long-term outcome after surgery. It was suggested that the more favorable outcome of women with esophageal cancer was associated with their earlier stages of esophageal cancer.

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Impact of age and sex on survival after curative resection for carcinoma of the esophagus

Cited by 25 publications

References 26 publications

Influence of Sex on the Survival of Patients With Esophageal Cancer

Influence of Sex on the Survival of Patients With Esophageal Cancer

Probing the link between oestrogen receptors and oesophageal cancer

Gender differences in clinicopathologic features and outcomes of esophageal cancer patients treated surgically

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